Individual
CLAYTON THOMAS ROLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
520 N 4TH ST, SPRINGFIELD, IL 62702-5238
(217) 545-8000
(217) 757-8161
Mailing address
PO BOX 19670, SPRINGFIELD, IL 62794-9670
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
125083003
IL
Other
Enumeration date
07/04/2023
Last updated
07/04/2023
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